TRANSMISSION OF CYTOMEGALOVIRUS VIA BREAST MILK IN LOW BIRTH WEIGHT AND PREMATURE INFANTS: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.53555/nnmhs.v9i5.1703Keywords:
Breast milk, Cytomegalovirus, Low birth weight, Premature, TransmissionAbstract
The human cytomegalovirus, also known as HCMV, is a herpesvirus that infects around sixty percent of people living in industrialized nations and more than ninety percent of adults living in developing nations. Because infections are typically kept under control by a robust immune response, patients typically have either no symptoms at all or only mild symptoms. Breast milk is regarded as the best diet for newborns because of the anti-infectious properties it possesses in addition to its high nutritional value; yet, breast milk can also act as a vehicle for the transmission of infectious diseases such as viruses and bacteria. Breast milk is the vehicle via which the great majority of human cytomegalovirus (HCMV)seropositive women pass the virus on to their children. Because their mothers have antibodies that are specific to HCMV, full-term neonates who acquire infections during pregnancy normally show no symptoms and do not experience any difficulties. In contrast, preterm neonates with very low birth weight (VLBW) are more likely to develop symptomatic infections, such as neutropenia, thrombocytopenia, sepsis-like syndrome, and, less frequently, pneumonia and enteric infection. These infections are more likely to occur in VLBW premature newborns. It would suggest that infections that are acquired postnatally clear up on their own without influencing the clinical result. We observe that there is still a risk of ASI-acquired CMV infection in premature newborns whose mothers have a positive CMV antibody test, although the rate of CMV infection is higher in premature infants who are fed fresh breast milk.
References
Griffiths P, Reeves M. Pathogenesis of human cytomegalovirus in the immunocompromised host. Nat Rev Microbiol [Internet] 2021;19(12):759–73. Available from: https://doi.org/10.1038/s41579-021-00582-z
Leruez-Ville M, Foulon I, Pass R, Ville Y. Cytomegalovirus infection during pregnancy: state of the science. Am J Obstet Gynecol. 2020;223(3):330–49.
Zuhair M, Smit GSA, Wallis G, Jabbar F, Smith C, Devleesschauwer B, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: A systematic review and meta-analysis. Rev Med Virol. 2019 May;29(3):e2034.
Korver AMH, Smith RJH, Van Camp G, Schleiss MR, Bitner-Glindzicz MAK, Lustig LR, et al. Congenital hearing loss. Nat Rev Dis Prim. 2017 Jan;3:16094.
Nagano N, Morioka I. Congenital cytomegalovirus infection: Epidemiology, prediction, diagnosis, and emerging treatment options for symptomatic infants. Expert Opin Orphan Drugs. 2020;8(1):1–9.
Mhandire D, Rowland-Jones S, Mhandire K, Kaba M, Dandara C. Epidemiology of Cytomegalovirus among pregnant women in Africa. J Infect Dev Ctries. 2019;13(10).
Bardanzellu F, Fanos V, Reali A. Human breast milk-acquired cytomegalovirus infection: certainties, doubts and perspectives. Curr Pediatr Rev. 2019;15(1):30–41.
Osterholm EA, Schleiss MR. Impact of breast milk‐acquired cytomegalovirus infection in premature infants:
Pathogenesis, prevention, and clinical consequences? Rev Med Virol. 2020;30(6):1–11.
Ross SA, Kimberlin D. Clinical outcome and the role of antivirals in congenital cytomegalovirus infection. Antiviral
Res [Internet] 2021;191:105083. Available from: https://www.sciencedirect .com/science/article/ pii/S0166354 221 000735
Kadambari S, Whittaker E, Lyall H. Postnatally acquired cytomegalovirus infection in extremely premature infants: how best to manage? Arch Dis Childhood-Fetal Neonatal Ed. 2020;105(3):334–9.
Weimer KED, Roark H, Fisher K, Cotten CM, Kaufman DA, Bidegain M, et al. Breast Milk and Saliva Lactoferrin Levels and Postnatal Cytomegalovirus Infection. Am J Perinatol. 2021 Aug;38(10):1070–7.
Narvaez-Arzate R V, Olguin-Mexquitic L, Lima-Rogel V, Noyola DE, Barrios-Compean LM, Villegas-Alvarez C. Cytomegalovirus infection in infants admitted to a neonatal intensive care unit. J Matern neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2013 Jul;26(11):1103–6.
Josephson CD, Caliendo AM, Easley KA, Knezevic A, Shenvi N, Hinkes MT, et al. Blood transfusion and breast milk transmission of cytomegalovirus in very low-birth-weight infants: a prospective cohort study. JAMA Pediatr. 2014 Nov;168(11):1054–62.
Omarsdottir S, Casper C, Navér L, Legnevall L, Gustafsson F, Grillner L, et al. Cytomegalovirus infection and neonatal outcome in extremely preterm infants after freezing of maternal milk. Pediatr Infect Dis J. 2015 May;34(5):482–9.
Romero-Gómez MP, Cabrera M, Montes-Bueno MT, Cendejas-Bueno E, Segovia C, Pastrana N, et al. Evaluation of cytomegalovirus infection in low-birth weight children by breast milk using a real-time polymerase chain reaction assay. J Med Virol. 2015 May;87(5):845–50.
Hosseini M, Esmaili HA, Abdoli Oskouei S, Gojazadeh M, MokariYamchi Z, Layegh V, et al. Evaluation of the Freeze-Thawing Method in Reducing Viral Load of Cytomegalovirus in Breast Milk of Mothers of Preterm Infants. Breastfeed Med Off J Acad Breastfeed Med. 2016 Dec;11:557–60.
Plosa EJ, Esbenshade JC, Fuller MP, Weitkamp J-H. Cytomegalovirus infection. Pediatr Rev. 2012 Apr;33(4):156– 63; quiz 163.
Hernandez-Alvarado N, Shanley R, Schleiss MR, Ericksen J, Wassenaar J, Webo L, et al. Clinical, virologic and immunologic correlates of breast milk acquired cytomegalovirus (CMV) infections in very low birth weight (VLBW) infants in a newborn intensive care unit (NICU) setting. Viruses. 2021;13(10):1897.
Pang J, Slyker JA, Roy S, Bryant J, Atkinson C, Cudini J, et al. Mixed cytomegalovirus genotypes in HIV-positive mothers show compartmentalization and distinct patterns of transmission to infants. Elife. 2020;9:e63199.
Patel RM, Shenvi N, Knezevic A, Hinkes M, Bugg GW, Stowell SR, et al. Observational study of cytomegalovirus from breast milk and necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2019 Jul;105(3):259–65.
Martins-Celini FP, Yamamoto AY, Passos DM, do Nascimento SD, Lima EV, Di Giovanni CM, et al. Incidence, Risk Factors, and Morbidity of Acquired Postnatal Cytomegalovirus Infection Among Preterm Infants Fed Maternal Milk in a Highly Seropositive Population. Clin Infect Dis an Off Publ Infect Dis Soc Am. 2016 Oct;63(7):929–36.
Buxmann H, Falk M, Goelz R, Hamprecht K, Poets CF, Schloesser RL. Feeding of very low birth weight infants born to HCMV-seropositive mothers in Germany, Austria and Switzerland. Acta Paediatr. 2010 Dec;99(12):1819– 23.
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